This Angel is pissed off. I'm Nurse Anne and I work on large general medical ward in the NHS. These are the wards with the most issues surrounding nursing care. The problems are mostly down to intentional understaffing by hospital chiefs that result in a lack of real nurses on the wards.
"The martyr sacrifices themselves entirely in vain. Or rather not in vain, for they merely make the selfish more selfish, the lazy more lazy and the narrow more narrow"-Florence Nightengale

Saturday, 5 December 2009

I am in the wrong job.

Read any of my posts on this blog about long shifts-no breaks- no help- multitasking-being held responsible for someone's death simply because you cannot be at once 10 places=constantly shifting between 12 hour days and 12 hour nights in the same week yada yada yada. Abuse Abuse Abuse.

That's what followed three years of hell at university that made my siblings' teaching and media degrees look like child's play. They'll tell you. Nursing school is something like DOUBLE the material to learn. Then you have to do thousands of hours of placements on top of that.

And I make less than a nanny, teachers, policemen-hell even cleaning ladies charge more per hour than what I earn. Now I learned about another occupation that out earns registered nurses...A DOG GROOMER.

Some Dog groomers can make in an hour what I make during 8 hours at work. For real.

£30-50 pounds for one medium sized dog (not mine) to have it's hair all trimmed, nothing fancy. it takes an hour. How many can they do a day? And they get to focus on one doggie at a time. Other groomers are quoting more money apparently.

Okay I worked 2 unpaid hours at the end of my shift the other day. No choice. Does anyone think that a doggie barber will cut my dog's hair for free since I don't always get paid for the work that I do?

Didn't think so. I still have to pay the childminder to look after my child for hours I didn't actually get paid for so....

God, you should see the look on the childminder's face when I pick my kid up 15 minutes late. She charges a pound a minute for lateness. She gives me a bitter lecture about how unfair it is that she has had to work an extra 15 minutes past her finishing time. My god. She was only looking after one child and she got £15.00 for working 15 minutes late. Twice that same week I had to stay over 2 unpaid hours past the end of my shift because patients went bad and there were no staff (luckily I was able to call Mr. Militant Medical Nurse and he was able to ditch out of work early and get our son-happens all the time-never marry a staff nurse). Staying over like this happens after many many hours of work looking after many difficult people with no break. And god forbid if I don't have a big smile on my face throughout that-the visitors make a bee-line to PALS to officially complain about the nurses looking like sour faced bitches.

Anyway I fired this childminder, but the rest of them are no better. Do people in other jobs really get to leave work on time and get paid for it when they don't? Brats. The childminder can even control how many children she looks after at one time. You won't see her forced to take on 20 of them and then accused of neglect and not caring when she cannot give one to one attention.

Can you imagine if registered nurses billed in the same way that these people do? Can you imagine if I charged £5-6 an hour per patient. I can have anywhere from 10-30 patients for 12 hours.

We should all become independent contractors and charge the hospitals for our services. At least then we could control our workload. I would never contract myself out to take more than 4 -6 patients at a time, at a cost of £5 an hour each. I'll charge so little for the important service I provide because I am nice and also want to be competitive. If the hospital or patient doesn't like me, they can sack me and find another. But really, how could I fail. I could do a hell of a good job as a nurse if I limited my patient load to 4 at a time. £5 an hour to keep your gran alive and care for her needs as well as managing and providing her doctors treatment plan. Even if I only charge what a childminder does I'll still be better off. Who can complain about a registered nurse wanting to earn like a childminder? I guess a lot of people would because if we billed as these people do and also controlled our workloads so that we can do a good job it would probably bring the whole health service down.

Anyway it's never going to happen so I am off to google "how to become a dog groomer?"

I guess I have a bit of attitude today. I think this is the first time I have posted bitching about pay. I usually try to avoid that subject. I have one more negative post coming after this and then a really positive one.

26 comments:

pissedoffmurse
said...

Pay...how many graduates start a job with EQUAL life or death responsibility for a smidge over 20k? To be fair, my SiL (lawyer) had a low start wage - the difference is after 1 year her pay has more than doubled :) A newly qualified staff nurse has to work their socks off to survive the first year, if they tick all the boxes what, another 1k? By the time you factor in tax credits and benefits, pretty much everybody in the hospital appears to earn the same as a staff nurse!

Its too true tho Anne. My friend is a teacher who has been qualified the same length of time as me...she earns a basic of £33K, £10K more than my basic, when you take into account the unsociable hours enhancements.

(and I don't LIKE working evenings, weekends and nights so I damned well expect to be paid a bit extra for it, even if it is taken off me again within the tax credits system!!)

My teacher friend cannot believe the life and death stories I tell her, the stress, the workload and the accountability. She feels bad for earning what she does, in comparison, to what i earn. My brother is a police officer and he feels the same. But hey, as you have regularly pointed out Anne, there is no respect for nurses in the NHS, why would they want to pay us more?! I'm sure they'd happily pay us less if they thought they could get away with it.

My brother's girlfriend isn't that bright but she got a job selling and promoting this dog food brand.

Her job consisted of dressing up and standing in different large chain pet stores trying to sell and promote this brand of dog food. She oooohed and ahhhhed over people's dogs, flirted with the male customers and offered free samples of dog food. She had a little card with health information about how wonderful the dog food was.

Her managers took her out for corporate lunches, she got to go to pet supply conventions etc.

2. If nursing actually billed for its hours as other disciplines do, people would sit up and take notice. In US hospitals medical bills don't even charge for nursing, it's all in there with the room rate.

childminders earn a fucking fortune and trust me on this one, the majority of them are lazy moos! Just about every single woman in my street is a child minder, lord knows why, mot of them congregate over one house most mornings for tea, fags and lunch whilst about 20 kids run riot in the house or sit on their assess watching TV. a toddler will hardly say "i sat and watched TV all day" the reason kids love their childminders so much is because they let them do whatever the fuck they want. it's so easy to get a damn licence to do it. end rant!

Reading the posts you'd have thought that you'd all been press-ganged into nursing? If you all hate your jobs so much and you think that life is greener on the other side...go there. The Government will probably just import more people to fill your shoes. Bear in mind when you slag off those patients or their visitors who you say complain unreasonably - they are only trying to do the best for themselves or their loved one. No less than you would do in their shoes.

They could help them better by trying to understand the situation and pressuring management. If they want mum to have one to one care they should pressure management to staff the wards.

The public is the...I hate to use this word...but they are the consumers. Therefore they are the only people management are going to listen to. They will listen to you a lot more than the nurses and the docs.

Tying up the nurses with abuse and unrealistic demands only slows them down and decreases the amount of stuff that they are going to be able to accomplish.

Nurses are not immune to being on the other side. We have all been sick and been at the bedside of our dying loved ones in hospital.

No they won't fill our shoes. They are losing staff via natural wastage and not replacing them. They think this saves them money. But it has simply created expensive complications for patients.

So yes I have been in their shoes and no I didn't behave like a 2 year old.

I know that if my gran's nurse is NOT coming to answer her bell right away it is because she is in the middle or dealing with something higher priority...and that this will be the case all shift and every shift and I know that management will not allow her to have any help.

I know that if my gran's nurse has 14 other patients that it means that she will NOT be able to attend to my gran promptly or provide basic care without killing someone else. Therefore I will fuck off and yell at management bypassing the nurse completely.

I know that if I ring all day to ask when that scan is going to be done that I am only going to slow the nurse down even more and create a dangerous possibly lethal situation with the interruptions. I also know that the nurse has no control over when the scan gets done. I know that it is illegal for the nurse to give results of the said scan out. Therefore I will not harass her with phone calls. And yes it is tough when you have a loved one in hospital and you don't know what is going on. But harassing and abusing the nurses just slows them down even more.

I would be really intereseted to know what those deleted comments said!! And why the author decided to delete them?

I've been an inpatient in hospital following major abdominal surgery. The nurses were fantastic, providing excellent basic AND complex care, running around like mad, but still taking a while to answer the call bells. I understood why, but the other patients in my bay didn't. They didn't know I was a nurse, and their critism's of the nurses was so unjust, because the standard of care we were ALL recieving was excellent. Some women was ringing the bell constantly, for stupid things, like having their pillows adjusted (when they could have EASILY managed it themselves), "move my water jug closer, what time will lunch be? Can i swap beds with her over there cos i wanna be closer to the window etc etc.." It was truly unbelievable. Then they were moaning about how long it was taking for bells to be answered.

I felt like yelling "well if everyone's ringing their bells for the same STUPID reasons as you lot, then no wonder its taking so long to get bells answered, you stupid lot, so stop moaning and stop ringing!".

I only rang my bell once, when I thought my bladder was going to explode all over the bed. If I could have waited for a nurse to come in anyway, rather than ring the bell, then I would have. And I'm sorry, but that is just common sense, and being of an non-demanding nature.

Some patients are just plain demanding, and I've seen that from a patients point of view now, not just from a nurses point of view.

I just wanted to add that we are not on here slagging off patients and families.

We are telling the truth, the whole truth and nothing but the truth. We are not going to sugar coat and we are not going to kiss ass.

Nursing care is a mess in hospitals all across the UK and many parts of the USA, Canada, etc. It is a goddamn mess.

The origins of all these problems began with people's attitudes towards nurses. If the public (including hospital bosses) actually had some kind of understanding of what a nurse really is the wards would be resourced and staffed appropriately. But they don't understand.

That is the whole point of this blog. Neither strike action or throwing more money at the problem, nor cracking down on the nurses themselves is going to solve anything if no one actually understands what a nurse has on her plate.

I have been doing this a long time and I have also been on the other side as a patient and a family member. I know what I am talking about.

Not all nurses are angels. I have had one or two sacked in my day. But the bad are far a few. Good nurses are failing miserably. We need people's perceptions of nursing in sync with reality in order to sort this situation out.

Ha Happy most of those deleted comments were mine because I cannot spell and type at the same time.

Have you noticed that most of these unrealistic demands, manipulative behaviour, passive aggressiveness and complaining come from women? I am sorry but it is true.

One of my patients was kicking off the other day, screaming at the nurses to stop and attend to her everytime they walked by. She was perfectly stable and able to mobilise by the way.

She talked none stop complaining about how horrible the nurses are etc etc. Never stopped. The patients next to her had their heads in their hands. I know that this kind of behaviour is the result of unrealistic expectations, fear and loss of control but that doesn't make it any easier to bear.

Finally a little old lady grabbed her zimmer frame, walked over to the woman and shouted " if you don't shut the fuck up I will strangle you goddammit".

"Reading the posts you'd have thought that you'd all been press-ganged into nursing? If you all hate your jobs so much and you think that life is greener on the other side...go there."

We actually love our jobs, Anonymous. Well I do! Its just the poor conditions that totally compromise patients care that we don't like. And the pay. Apart from that Anonymous, nursing is an absolute pleasure!

And I agree Anne, it is definately female patients than complain and demand the most! I love looking after elderly men - they are my favourite. Usually chirpy, grateful and full of stories of days gone by to keep us amused. Bless 'em.

I'm thinking the person who posted that "they" will just import more nurses is either totally out of touch with reality or a troll. It is so typical for non-nurses to view us as dispensable commodities. But let them need one and they're cursing us for not tending to them in a timely enough manner. Whatever! Most nurses go into the "profession" for altruistic reasons. But we still have to eat and keep a roof over our heads. We are not allowed to do the job we were trained to do anymore - not just because of patient load, but because of heavy throughput. Get 'em in and get 'em out! Hurry hurry hurry!So what if a patient needs to be intubated right away or he goes into full arrest? The other bed is empty and we need to fill it now! It's terrible that nurses are up against such an ignorant public. I am just biding my time till I can get out. I'm a good nurse. Once upon a time, I liked my job. But enough is enough! I can't stand it anymore. Two work-related back injuries this year because we have no lifting help. Being badgered about calling in sick while I was in the waiting room at the doctor's office. Only time I've had to be out except for the work-related injuries and a death in the family. Enough is enough. My degree did not afford me the respect or professional courtesy that other degreed people take for granted. Good luck, Anne. I'm just waiting for my husband to finish his certification process so I can go back to school for a non-nursing degree and have a chance at a real life. In the meantime, I am proud that I have saved a life by telling my aunt who was thinking about pushing her daughter to do nursing that if she truly loved her daughter at all, she would NOT encourage her to go into nursing. She's already a personal trainer, and she could go out on her own and make more money than I can with nursing. And there is no way I would join the ranks of "consultants" who have given the Judas kiss to bedside nurses by telling hospital admin to eliminate their jobs. I am so turned away from nursing at this point, I would not think of spending a red dime on pursuing a master's degree in it either. :(

They think a nurse is like a hotel porter. Minimum wage, no brains, can sack them if they don't do as their told and can replace with anyone off the street. It is also more difficult than your average 3 year degree. And the foreign registered nurses coming in do indeed have that level of education under their belts. If they didn't the NMC would not license them to practice in the UK as nurses. Nothing to stop them from working as care assistants though.

The training for nurses is a hell of a lot more difficult than the training programs for teaching, social workers etc.

A nurse also has a lot more professional accountability along with all that life and death responsibility.

Try telling the to peeps around here and their fucking eyes glaze over.

In an atmosphere if universal deceit telling the truth is a revolutionary act. George Orwell.

Why has Nursing Care Deteriorated

Good nurses are failing every day to provide their patients with a decent standard of care. You want to know what has happened? Read this book and understand that similiar things have happened in the UK. Similiar causes, similiar consequences. And remember this. The failings in care have nothing to do with educated nurses or nurses who don't care. We need more well educated nurses on the wards rather than intentional short staffing by management.

About Me

I am a university educated registered nurse. We had a hell of a lot of hands on practice as well as our academic courses. The only people who say that you don't need a brain or an education to be an RN are the people who do not have any direct experience of nursing in acute care on today's wards. I have yet to meet a nurse who thinks that she is above providing basic care. I work with nurses who are completely unable to provide basic care due to ward conditions.
I have lived and worked in 3 countries and have seen more similarities than differences. I have been a qualified nurse for nearly 15 years. I never used to use foul language until working on the wards got to me. It's a mess everywhere, not just the NHS.
Hospital management is slashing the numbers of staff on the ward whilst filling us up with more patients than we can handle... patients who are increasingly frail. After an 8-14 hour shift without stopping once we have still barely scratched the surface of being able to do what we need to do for our patients.

Quotes of Interest. Education of Nurses.

Hospitals with higher proportions of baccalaureate-prepared nurses tended to have lower 30-day mortality rates. Our findings indicated that a 10% increase in the proportion of baccalaureate prepared nurses was associated with 9 fewer deaths for every 1,000 discharged patients."...Journal of advanced nursing 2007

THIS MEANS WE NEED WELL EDUCATED NURSES AT THE BEDSIDE NOT IN ADVANCED ROLES

Dr. Linda Aiken and her colleagues at the University of Pennsylvania identified a clear link between higher levels of nursing education and better patient outcomes. This extensive study found that surgical patients have a "substantial survival advantage" if treated in hospitals with higher proportions of nurses educated at the baccalaureate or higher degree level.

THIS MEANS WE NEED WELL EDUCATED NURSES AT THE BEDSIDE NOT IN ADVANCED ROLES

Dr. Linda Aiken and her colleagues at the University of Pennsylvania's Center for Health Outcomes and Policy Research found that patients experienced significantly lower mortality and failure to rescue rates in hospitals where more highly educated nurses are providing direct patient care.

Evidence shows that nursing education level is a factor in patient safety and quality of care. As cited in the report When Care Becomes a Burden released by the Milbank Memorial Fund in 2001, two separate studies conducted in 1996 - one by the state of New York and one by the state of Texas - clearly show that significantly higher levels of medication errors and procedural violations are committed by nurses prepared at the associate degree and diploma levels as compared with the baccalaureate level.

Registered Nurse Staffing Ratios

International Council of Nurses Fact Sheet:

In a given unit the optimal workload for a registered nurse was four patients. Increasing the workload to 6 resulted in patients being 14% more likely to die within 30 days of admission.

A workload of 8 patients versus 4 was associated with a 31% increase in mortality. (In the NHS RN's each have anywhere from 10-35 patients per RN. It doesn't need to be this way..Anne)

Registered Nurses in NHS hospitals usually have between 10 and 30+ patients each on general wards.

Earlier in the year, the New England Journal of Medicine published results from another study of similar genre reported by a different group of nurse researchers. In that paper, Needleman et al3 examined whether different levels of nurse staffing are related to a patient’s risk of developing complications or of dying. Data from more than 5 million medical patient discharges and more than 1.1 million surgical patient discharges from 799 hospitals in 11 different states revealed that patients receiving more care from RNs (compared to licensed practical nurses and nurses’ aides) and those receiving the most hours of care per day from RNs experienced fewer complications and lower mortality rates than those who received more of their care from licensed practical nurses and/or aides. Specifically for medical patients, those who received more hours per day of care from an RN and/or those who had a greater proportions of their care provided by RNs experienced statistically significant shorter length of stay and lower complication rates (urinary tract infections, gastrointestinal bleeding, pneumonia, cardiac arrest, or shock), as well as fewer deaths from these and other (sepsis, deep vein thrombosis) complications

•Lower levels of hospital registered nurse staffing are associated with more adverse outcomes such as Pneumonia, pressure sores and death.
•Patients have higher acuity, yet the skill levels of the nursing staff have declined as hospitals replace RN's with untrained carers.
•Higher acuity patients and the added responsibilities that come with them increase the registered nurse workload.
•Avoidable adverse outcomes such as pneumonia can raise treatment costs by up to $28,000.
•Hiring more RNs does not decrease profits. (Hospital bosses don't understand this. They think that they will save money by shedding real nurses in favour of carers and assistants. The damage done to the patients as a result of this costs more moneyi.e expensive deaths, complications,and lawsuits, and complaints....Anne)

Disclaimer

I know I swear too much. I am truly very sorry if you are offended. Please do not visit my blog if foul language upsets you. I want to help people. That is why I started this blog and that is why I became a Nurse. I won't run away from Nursing just yet. I want to stick around and make things better. I don't want the nurses caring for me when I am sick working in the same conditions that I am. Of course this is all just a figmant of my imagination anyway and I am not even in this reality. Or am I?Any opinions expressed in my posts are mine and mine alone and do not represent the viewpoint of the NHS, the RCN, God, or anyone else.